Vitamin B-12-fortified toothpaste improves Vitamin status in vegans: A 12-wk randomized placebo-controlled study

Abstract

Background: The oral application of Vitamin B-12 may prevent its deficiency if the Vitamin is absorbed via the mucosal barrier. Objectives: We studied the effect of the use of a Vitamin B-12-fortified toothpaste on vitamin-status markers in vegans and assessed the efficiency of markers in the identification of vitamin-augmentation status. Design: In this 12-wk, double-blinded, randomized, placebocontrolled study, 76 vegans received either a placebo (n = 34) or Vitamin B-12 (n = 42) toothpaste. Sixty-six subjects (n = 30 in the placebo arm; n = 36 in the Vitamin B-12 arm) completed the intervention. Serum and plasma concentrations of Vitamin B-12, holotranscobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA) were measured before and after the intervention. Results: Both postintervention concentrations of Vitamin B-12 and holotranscobalamin and their changes over 12 wk were higher in the Vitamin B-12 group (mean ± SD change: 81 ± 135 pmol/L for Vitamin B-12 and 26 ± 34 pmol/L for holotranscobalamin) than in the placebo group (227 ± 64 and 25 ± 17 pmol/L, respectively) after adjustment for baseline concentrations. Postintervention concentrations of MMA and their changes differed significantly between groups (MMA changes: 20.169 ± 0.340 compared with 20.036 ± 0.544 mmol/L in Vitamin B-12 and placebo groups, respectively; P < 0.001). After adjustment for baseline tHcy, postintervention concentrations of tHcy tended to be lower (P = 0.051), and the changes in tHcy (20.7 ± 4.4 compared with 2.0 6 5.6 mmol/L, respectively) were greater in the Vitamin B-12 group than in the placebo group. Changes in Vitamin B-12 markers were more prominent in vegans who reported that they had not taken Vitamin B-12 supplements. Conclusion: Vitamin B-12 that is applied to the oral cavity via toothpaste enters the circulation and corrects the Vitamin B-12 markers in the blood of vegans who are at higher risk of Vitamin B-12 deficiency.